HomeMy Public PortalAbout5121 GOLDEN WEST AVE_Plumbing__ "AGGTC (Ci-8175) -9/75
APPLICATION FOR PLUMBING PERMIT
BUILDIN AND SAFETY DIV N
FOR APPLICANT TO FILL IN (PRINT OR TY PEI BUILDING J
NUMBER FIXTURE OR ITEM • FEE ADDRESS /
WATER CLOSET LOCALITY /
NEAREST �� p
BATH TUB CROSS ST.
SHOWER OWNER `
LAVATORY MAI L
ADDRESS
SINK CITY TEL. NO.
DISHWASHER CONTRACT
CLOTHES WASHER
ADDRESS1
0144
SWIMMING POOL RECEPTOR
L
LAWN SPRINKLER SYSTEM LLSTATELIC ,gyp
WATER HEATER L I CEN E NO. O �o CLASS
DISTRICT N0. UP ZON �OCEY G�
GAS SYSTEM OUTLETS ' _
OUTLETS OVER D�JS�R✓Iq[�O�
6 PER SYSTEM WA57E APPROVAL y
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Addres$ ROUGH PLUMBING
City Tel. NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AMD STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR PLUMBING FIXTURES
Ll
SED AS REOUI RED BY LOS ANGELES COUNTY AND STAT[ OF GAS TEST
ORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
E IN THE ABOVE DESCRIBED RESIDENTIAL R [R TY. UTILITY CO. NOTIFIED
A TU RE
PERMITTEE FINAL "� -t •�
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.0. CASH
3 5 5SfP 27
' COUNTY OF L0S ANfIFL&S TE241PLE CITY # 0508 PLUMBING PERMIT
DEPARTWNT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1212110035
BUILDING AND SAFETY / LAND nEVELOPMENT TEMPLE CITY CA 91780
PHOVE: (626) 285-0489 ETT:
LEGAL ID: FEES PAID BU=1NG ADDRESS:
TR: 15683 LT: 10 5121 GOLDEN WEST AV
FEE DESCRIPTION: QUANfIT'Y: UCW AMOUNT: TEMP_ CA 917803941
ASSESSOR ENPO ON NUMBER: NEAREST CROSS STREET:
8589-010-010 01 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A4 LOCALITY: T134PLE CITY CA
07 BATHTUBS/SHOWERS 3.00 FII 48.60
TENANT: 11 CLOTH&SWASHER(S) 1.00 Fu 16.20 ISSUED ON: PROCESSED BY: PLAN BY:
13 DISHWASHER(S) 1.00 FIX 16.20 12/11/12 SR
21 HOSE BIRB(S) 2.00 FIY 32.40
OWNER: TEL. NO: 25 LAVATORIESET/UR - - 7.00 FIX 113.40 INAL DATE FINAL BY: CODE:
TRAM, ERSS'I'RA (626) 755-1474- 45 WATER CLOSET/IIRI2DlL 3.00 FII 48.60f"nr 1 /„1AI�`J
5121 GOLDEN WEST AV 47 tiATFF R HEATER(9) 1.00 WPH 16.20
TENT 917803941 51 Li0'W PRS GAS 5 CUTLET 1.00 SYS 16.20 DRACRIPT-110S OF WORK
TOTAL FEES 335.60 BATRTUB/SHOWER, DISHWASHER, CIATHE�R, HOBS BIBBS,
LAVATORIES, SIN”, IQ17.'ER CLAS&TS, 1Q+TER HRATF'R AND GAS T.
APPLICANT: TEL. NO:
CHAN, TEREiCE _ (626) 379-4900-
�60 W MAIN ST C278 SPECIAL COND=ONS:
ALHAMBRA C71 91801
CONTRACTOR: TEL. NO: APPROVALS BATE INSPECTOR SIGNATURE
LAN RI3 INC (626) 379-4900-
560 W MAIN STREET #0278 LIC. NO UNDER SLAB WORK
ALHAMBRA CA 91801 668443
WA
C YIN YIN
ARCHITECT OR ENGIN"EA2: TEL. NO:
CHAN, TEltREWC3 (626) 379-4900- ING
560 W }AIN ST 0278 LSC. NO:
ALHAMBRA CA 91801 NONE GAS PIPING
GAS VENT
HOT WATER HEATER
PI;0WING FIXTURES
LAWN 9 PR TT11 LEL S
CCAS TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
+ ADDITIONAL BATA ON FILE
REPORT ID: DPP-263 ROUTE TO: 1390508